Horrible eczema tx in kid >1 yo

Clobetasol x 5-7 days then switch to TAC right away QD

OR TAPERclobetasol x 4days then 10 days of Fluocinonode 0.05, then TAC QD

17

What to tell pt about Patch testing

And Brand name for it / how many allergens has

Put on Monday and can’t shower for 5 days bc take off Friday

Done for allergic contact dermatitis

Brand name is TRUE test has 38 allergens

18

Which toothpaste to use if mouth or lip rash/ soreness

Arm and Hammer

19

Taper prednisone for severe contact derm

And what to check when doing taper?

40 mg x 1 week (20 BID)20 mg x 2 weeksNot more than 3 weeks

SE: jittery, adrenal suppression, joint aches

Check BP and DM (ok if controlled)No glaucoma (ok but see eye doc next week - meaning ok to give cortisol to someone with glaucoma but tell them to see eye doc next week?)Can worsen infection - can’t give if cocci, PNA

Rare risk: aseptic necrosis of hip = hip fracture

20

What to do if give IM Kenalog for contact derm

Max number of IM Kenalog shots per year

Pull back to make sure not in artery40 mg IM

Max 2 per year (risk osteoporosis, muscle weakness)

21

Tx for seb derm on face

Am: ketoconazole cream wAMPM: 2.5 HCUse H&Sh aids on face

Alternate shampoos from Selsum, head and shoulders and nizerol bc yeast can build up resistance

Shaving is ok bc not a fungus

Caused by yeast not fungus

22

Which test to order in dermatomyocitis

Which is the #1 underlying cause of it?

Order transvaginal US (ovarian cancer is #1 cause of underlying malignancy - which is cause in 26% of DM)

Also order:CBCSed rateSPEP

(Also full body cat scans???)

All age appropriate screening:Colonoscopy at 50 yoMammo at 40 yo

23

If pt is itching during exam, what is the likely etiology of itch

Paraneoplastic or drug induced: deep itch

24

What to tell a pt who is lying on abdomen for excision or EDC - during electrocautery

Make sure not to touch the metal rails on the bed during electrocautery

25

New guidelines for MM SNL biopsy, at which depth to offer SNL bx

At 0.80 mm -

Per Dr. O - he refers to plastics for SLN bx at 0.75 depth

26

Which type of cancer doubles the risk of MM?

Breast cancer (BRCA) double the risk of MM

27

MM puts a pt at risk of which other cancers?

BreastPancreaticOvarian/uterineCOLONStomachProstate

28

Onycholisis is due to

Lifting of nail plate due to overwashong - nailtique

29

Fever and red tender rapidly expanding nodules/plaques (sometimes with vesicles or pustules) is associated with which disorder?

What has to be done when cauterizing a pt on oxygen

Turn off oxygen for a couple minutes ALWAYS

What is brittle nails

Onychorrhexis

Use Biotin OTCNailtique #2 at Sally beauty supply store

What does Haley Haley look like and how is it different?

Looks like chronic intertrigo but with fissures that bleed and had them all their lives

Hard to tx, inherited

128

Which dz looks like chronic intertrigo but with fissures and bleeding

Haley Haley

129

If see unilateral intertrigo, what’s on your DDx?

Paget’s (extramammory)

130

Bluepheritis

Inflamm of eyelids

AllegraAquaphor for eyelids

131

What is the name of the benign growth on the upper palate?

Torus palatines

132

Which antibodies are associated with scleroderma

Scl-70 which are bad prognosis

It’s an autoimmune disorder with no good tx. Results in skin tightening and thickening, raynaud, and visceral dz.

Avoid cold, don’t smoke, PT to increase mobility of thickened skin

133

What is the name of nose condition in rosacea

Rhinophyma

134

What is erythrasma, how looks, cause

Axilla,

looks like intertrigo much more Copper than TINEA cruris

Caused by corynebacterium

135

How to dx erythrasma

Tx

Wood lamp - coral color from porphorins

but no one uses lamp bc tx is same for all - erythrasma, TINEA cruris: ketoconazole has mild anti G+ and anti inflammatory effect. Also for all: keep area dry, white cotton boxers, ZAsorb, hairdryer, change socks/ boxes thru day

Top erythromycin or Clindamycin Oral erythromycin and top miconazole

136

What is balanitis

Inflammation of glans penis

137

When looking at large sebatious hyperplasia, what’s on your ddx?

It’s associated with what disease?

Sebatious adenoma (benign but excise)

Muir Torre

138

What is Muir Torre?

What to ask the pt?

Autosomal dominant (50% of your kids will inherit it so check/advise kids to get colonoscopy)

Any family history of colon cancer?Have you had your colonoscopy?Any history of bladder cancers? (PersonalOr family?) (ask PCP to check irons cytology)Any history of breast cancer?

Also high risk of lymphoma and leukemia

139

What can look like stye on eyelid?

Sebatious adenoma or carcinoma

140

What does it mean if you have a sebaceous adenoma below the neck?

Or more than one SA?

Higher risk of Muir Torre syndrome

141

When pt has rash when normally covered areas are exposed to sun

Polymorphous light eruption

142

Lipomas around neck are called

Madelons

143

What are 8 types of physical urticaria

What are the top 3 types of physical urticaria

Dermatograph is #1Cholinergic #2 (increase in body temp thru exercise or hot baths)Cold #3 (exposure to cold results in edema in those areas)

Pressure (3-12 hr after pressure, MC feet and buttocks after sitting)

Fat bump in feet

Pezogenic petopapule

Ear dandruff drops

DermOtic oil 0.01% (fluocinolone)Sig: 5 drops in each ear BID

Change shampoo to nizerol otc

Frontal fibrosing Alopecia is a subtype of which disorder and has what?

LPP

lose hairs

147

The other tx for scabies

Ivermectin pills

148

Nails that grow out without being cut

Onychogriphosis

149

White spots on toes and nails

Leukonychia

150

Cartilage proliferation

Weathering nodule (when bump is not inflamed)

151

How long must be on 2 forms of OCP after stop accutane tx?

2 months after stop Accutane

152

Benign reactive proliferation of capillary blood vessels is called

(and not to be confused with)

Pyogenic Granuloma

(Don’t confuse with Pyoderma gangrenous - ulcers rapidly enlarging and painful (neutrophilic dermatosis, not infection), Starts suddenly as smal pimple often at site of injury then breaks down to form an ulcer)

153

ulcers that are rapidly enlarging and painful (neutrophilic dermatosis, not infection), Starts suddenly as smal pimple often at site of injury then breaks down to form an ulcer

Pyoderma Gangrenosum

Not infection

154

Which disease is associated with Celiac?

Dermatitis Herpetiformis

90% of DH pts have celiac disease (but not all pts with celiac have herpetiformis)

155

How to ddx T. Versicolor from Progressive macular hypomelanosis

T Versi has scale

156

Skin discoloration/redness and swelling due to exposure to cold (2 names)